@article{ref1,
title="Single episode of major depressive disorder. First episode of recurrent mood disorder or distinct subtype of late-onset depression?",
journal="European archives of psychiatry and clinical neuroscience",
year="1993",
author="Cassano, G. B. and Akiskal, Hagop S. and Savino, M. and Soriani, A. and Musetti, L. and Perugi, G.",
volume="242",
number="6",
pages="373-380",
abstract="Of 687 consecutive inpatients and outpatients with primary major depressive illness, 213 (31%) were categorized as single episode (SE) by DSM-III-R criteria. Systematic evaluation of familial, sociodemographic, temperamental and symptomatological characteristics permitted the nearly equal division of SE into two categories: a. early-onset (< 45 years) &quot;first episode&quot; superimposed on either depressive or hyperthymic temperaments (against a bipolar and unipolar familial background), more severe depression, higher rates of suicide attempts, greater anxiety-somatization and psychotic tendencies, and with the potential for recurrence; b. late-onset (> or = 45 years) isolated episode (against an unipolar familial background) with greater life stressors, pursuing a protracted course with less likelihood of recurrence. In most other respects, early-onset SE was intermediate between recurrent major depression and late-onset SE. The implications of these findings for the now largely abandoned category of &quot;involutional melancholia&quot; are discussed.<p /><p>Language: en</p>",
language="en",
issn="0940-1334",
doi="",
url="http://dx.doi.org/"
}